Abstract
In 10 patients with a reflex urinary bladder after a cervical or high thoracic spinal cord injury, the effect of nifedipine on the cystometry-induced elevation of blood pressure was studied. The blood pressure was measured every 30 s in four consecutive cystometries before and after administration of 10 mg nifedipine sublingually. In each patient there was a decrease in the maximum systolic and diastolic blood pressure after the administration of nifedipine. In the whole group the mean maximum systolic pressure decreased significantly from 147 mmHg (range 119-165, SD 14) to 118 mmHg (range 99-145, SD 14). The mean maximum diastolic pressure decreased from 110 mmHg (range 96-124, SD 10) to 83 mmHg (range 71-99, SD 10). The effect of nifedipine was significant in each of the four cystometries that were performed. The decrease in blood pressure was due to both a significant decrease of the baseline pressure and a significant decrease of the blood pressure reaction during cystometry. Nifedipine may be useful in order to prevent dangerous blood pressure reactions, e.g. during cystoscopy and other diagnostic or therapeutic procedures in spinal cord injured patients with autonomic dysreflexia.
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References
Guttmann L, Whitteridge D (1947) Effects of bladder distension on autonomic mechanisms after spinal cord injuries. Brain 70: 361–404.
Lindan R, Leffler E J, Kedia K R (1985) A comparison of the efficacy of an alpha-I-adrenergic blocker and a slow calcium channel blocker in the control of autonomic dysreflexia. Paraplegia 23: 34–38.
Dykstra D D, Sidi A A, Anderson L C (1987) The effect of nifedipine on cystoscopy-induced autonomic hyperreflexia in patients with high spinal cord injuries. J Urol 138: 1155–1157.
VerVoort S M, Donovan W H, Dykstra D D, Syers P (1988) Increased current delivery and sperm collection using nifedipine during electroejaculation in men with high spinal cord injuries. Arch Phys Med Rehabil 69: 595–597.
Thyberg M, Ertzgaard P, Gylling M, Granerus G (1992) Blood pressure response to detrusor pressure elevation in patients with a reflex urinary bladder after a cervical or high thoracic spinal cord injury. Scand J Rehabil Med 24: 187–193.
Thyberg M, Gedda S, Johansen P B, Lassvik C, Spångberg A, Engberg A (1989) Continuous monitoring of detrusor pressure in patients with a reflex urinary bladder after spinal cord injury. Scand J Rehabil Med 21: 115–121.
Thyberg M, Spångberg A, Lassvik C (1990) Detrusor pressure in cystometry compared to physiological filling in patients with a reflex urinary bladder after spinal cord injury. Scand J Rehabil Med 22: 145–150.
Bartorelli C, Magrini F, Moruzzi P, Olivari M T, Polese A, Fiorentini C et al 1978 Haemodynamic effects of calcium antagonist agent (nifedipine) in hypertension-therapeutic implications. Clin Sci Mol Med 55: 4: 291s–292s.
Forman A, Andersson K, Henriksson L, Rud T, Ulmsten U (1978) Effects of nifedipine on the smooth muscle of the human urinary tract in vitro and in vivo. Acta Pharmacol Toxicol 43: 111–118.
Hoyo-Vadillo C, Castaneda-Hernández G, Herrera J E, Vidal-Gárate J, Salazar L A, Moreno-Ramos A et al 1989 Pharmacokinetics of oral nifedipine-relevance of the distribution phase. J Clin Pharmacol 29: 251–256.
Aoki K, Sato K, Kawaguchi Y, Yamamoto M (1982) Acute and longterm hypotensive effects and plasma concentrations of nifedipine in patients with essential hypertension. Eur J Clin Pharmacol 23: 197–201.
Kleinbloesem C H, Van Brummelen P, Van de Linde J A, Voogd P J, Breimer D D (1984) Nifedipine-kinetics and dynamics in healthy subjects. Clin Pharmacol Ther 35: 742–749.
Shettigar U R, Loungani R (1989) Adverse effects of sublingual nifedipine in acute myocardial infarction. Crit Care Med 17: 196–197.
Boden W E, Korr K S, Bough E W (1985) Nifedipine-induced hypotension and myocardial ischemia in refractory angina pectoris. JAMA 253: 1131–1135.
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Thyberg, M., Ertzgaard, P., Gylling, M. et al. Effect of nifedipine on cystometry-induced elevation of blood pressure in patients with a reflex urinary bladder after a high level spinal cord injury. Spinal Cord 32, 308–313 (1994). https://doi.org/10.1038/sc.1994.53
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DOI: https://doi.org/10.1038/sc.1994.53
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